Lack of X-rays blamed for girl’s arm operations

Doctor argues it wouldn’t have revealed a problem necessitating any surgery

In a lawsuit filed in Ingham County Circuit Court, plaintiff John Kobus, serving as next friend to plaintiff minor Leigha Kobus, sought compensatory damages from defendant Dr. John Putz, on claims of medical malpractice stemming from a forearm fracture.

On June 25, 2007, Leigha Kobus, 9, fell and fractured both bones in her left forearm. After X-rays were taken, Putz performed a closed reduction of the fractures and placed her arm in a splint. No post-reduction X-rays were taken. Four days later, Putz removed the splint and placed the arm in a cast. No X-rays were taken, and Putz instructed Leigha to return in six weeks.

On Aug. 6, the cast was removed, revealing a significant deformity of the arm. X-rays showed angulation and bayoneting of both forearm bones. On Aug. 20, Leigha underwent surgery by another physician to correct the angulation, with hardware installed.

Because of postsurgical healing problems, and non-union of one of the forearm bones, Leigha was in and out of a cast for more than a year. On Nov. 11, 2008, she underwent a second surgery to remove the hardware. Other than two 8-inch-surgical scars on forearm, she had no complaints.

Plaintiff argued that the standard of care required X-rays after the reduction, immediately after casting, and two weeks thereafter; defendant and defense experts each testified they would usually take X-rays as suggested by plaintiff. Plaintiff further contended that such X-rays would have revealed a loss of reduction, which would have allowed for a second closed reduction and avoidance of surgery.

Defendant contended that, although X-rays usually are taken given the circumstances of the situation, X-rays are not required by the standard of care. It also was asserted there was no evidence that an earlier X-ray would have revealed a problem necessitating surgery.

The jury found for the defendant and issued a no-cause-of-action verdict. (Prior to trial, Sparrow Hospital was dismissed from the claim as a co-defendant, as it and plaintiff accepted a $10,000 case evaluation award.)

Type of action: Medical malpractice

Type of injuries: Surgery to repair a two-bone forearm fracture with hardware, followed by second surgery to remove the hardware, leaving two 8-inch-surgical scars on forearm